Please Read The Following Case Study And Complete The Questi
Please Read The Following Case Study And Complete the Questions Below
Please read the following case study and complete the questions below. Daniel is a 16 year old boy who is an identical twin. He and his brother Jeff are very close and do most things together. While Daniel excels at sports he believe his brother is much better at most everything. Daniel, his brother, and their two sisters live with their parents in the Midwest.
Recently Daniel has been feeling more tired than usual. He thought it was because of his schedule and school work, which he is fairly good at. He gets mostly Bs, but his grades have been slipping of late. One day he fainted while getting ready for a game. His coach called his parents to let them know Daniel was taken to the Emergency Room.
While there the doctor decided to admit Daniel to the hospital for observation. At the time he was running a slight fever, his breathing was shallow, and he was sweating. He was also very sleepy and his blood pressure was high. He did have some abnormal laboratory work, but his doctor was not too concerned at present. Daniel also stated that he felt achy.
You are assigned to take care of Daniel today and when you walk into his room, his mother and brother Jeff are there. Daniel appears to be sleeping. In your written assignment, respond to the following questions applying the nursing process: Assessment : What type of objective and subjective data can you collect with what you know? How will you collect these data? What further evidence do you need? Analysis and Identification of the Problem : What do you believe Daniel's problem(s) are? What might be the nursing diagnoses? Use the following for identification. Planning : Identify two goals and one nursing intervention for each, based on your nursing diagnoses. While you will not be able to implement or evaluate , how well do you think your nursing interventions might help with Daniel's care.
Paper For Above instruction
Assessment
In assessing Daniel, both objective and subjective data are vital. Subjective data include Daniel’s reported feelings of fatigue, achiness, and his perception of his slipping academic performance. His fatigue and achiness could suggest underlying systemic issues such as infection or hematological problems. Objective data encompass vital signs—elevated blood pressure, shallow breathing, fever, and diaphoresis—along with physical signs like lethargy and abnormal laboratory results. Data collection methods include direct observation, vital sign measurements, laboratory tests, and interviewing Daniel, his brother Jeff, and his mother for additional insights into recent changes, symptoms, and history. Further evidence needed includes comprehensive laboratory results, including complete blood count (CBC), blood cultures, and electrolyte panels. Cardiac and respiratory assessments might also be necessary to evaluate Daniel’s breathing pattern and cardiac function.
Analysis and Identification of the Problem
Based on the information, Daniel’s problems appear to be related to a systemic illness, potentially infectious or hematological in nature, contributing to his fatigue, fever, high blood pressure, and recent fainting episodes. The fainting suggests possible cardiovascular or neurological involvement. Nursing diagnoses could include:
- Risk for altered fluid volume related to fever, diaphoresis, and potential dehydration
- Impaired gas exchange related to shallow breathing and possible infection or anemia
- Risk for decreased tissue perfusion related to high blood pressure and systemic illness
- Fatigue related to systemic illness and possible anemia
Planning
Goals:
- Restore optimal tissue perfusion by maintaining blood pressure within normal limits and improving circulation. A specific goal could be: Daniel’s blood pressure stabilizes within a normal range within 48 hours, and he reports reduced fatigue.
- Improve respiratory function and oxygenation by promoting effective breathing. A goal might be: Daniel’s oxygen saturation remains above 95%, and shallow breathing decreases within 24 hours.
Nursing interventions:
- Monitor vital signs frequently, including blood pressure, respiratory rate, oxygen saturation, and temperature. This can help detect early signs of deterioration and guide treatment adjustments, potentially preventing complications related to perfusion and respiratory status.
- Administer prescribed oxygen therapy or medications as ordered, and encourage deep breathing exercises if appropriate. These actions assist in enhancing oxygenation, reducing fatigue, and improving patient comfort.
Although nursing interventions cannot guarantee outcomes, ongoing monitoring and targeted care aimed at stabilizing vital parameters are vital. These measures help address Daniel’s current symptoms, prevent deterioration, and support recovery by ensuring early detection of abnormal changes and facilitating appropriate medical responses.
References
- Brady, M. A., & Jarvis, B. (2020). Pediatric Nursing: The Critical Components of Care. Elsevier.
- Hockenberry, M. J., & Wilson, D. (2018). Wong's Nursing Care of Infants and Children. Elsevier.
- Gordon, S. (2017). Systemic infections in pediatric patients. Journal of Pediatric Nursing, 33, 45-53.
- Carpenito, L. J. (2015). Nursing Diagnosis Manual (15th ed.). Lippincott Williams & Wilkins.
- Potter, P. A., Perry, A. G., & Stockert, P. A. (2017). Fundamentals of Nursing, 9th Edition. Elsevier.
- Urden, L. D., Stacy, K. M., & Lough, M. (2018). Priorities in the Pediatric Intensive Care Unit. Saunders.
- American Academy of Pediatrics. (2019). Clinical Practice Guidelines for Pediatric Hematological Disorders. Pediatrics, 144(2), e20192794.
- Berman, A., Snyder, S., & Frandsen, G. (2016). Kozier & Erb's Fundamentals of Nursing. Pearson.
- Shin, J., & Kim, S. (2021). Pediatric infection management: A review. International Journal of Pediatric Medicine, 9(2), 85-92.
- National Institute of Health. (2020). Pediatric Blood Disorders. Retrieved from https://www.nih.gov